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About candidal infections

Candidal infection of the breast is a controversial topic and practitioners are divided in their opinions.

However, clinical breastfeeding medical specialists recommend that candidal infections of the nipples and breast should be considered when a lactating woman, who has mastitis, develops what has been classified as the classic symptoms of candida.

It is difficult to obtain a positive culture for candida from a breast milk sample.

There may be a history of antibiotic treatment in pregnancy or during labour.

Typical symptoms

Typical symptoms are:

  • Burning nipple pain
  • Pain radiating through the breast
  • Stinging sensation in the nipples and breast.

Signs

  • There may be no obvious signs although the nipple and areola may sometimes have a shiny appearance.
  • White patches may be seen but this is rare.
  • The baby may or may not have signs of oral and nappy-area thrush infection.

Treatment

  • Antifungal treatment for both the mother and baby.
  • Topical application to the nipples and also to the baby’s mouth and nappy area if necessary (Nystatin).
  • Systemic treatment of the woman may be necessary and fluconazole is used by medical breastfeeding specialists ( Lawrence & Lawrence; Newman; Academy of Breastfeeding Medicine).
  • Some practitioners recommend taking care with clothing that comes into contact with infected areas and recommend washing these items daily.
  • Support continued breastfeeding and ensure the latching and positioning for breastfeeding are optimal.